When my son had his first migraine attack, he was 12, and we both immediately knew what was happening.
I’ve had migraine most of my life – 40ish years of episodic migraine attacks, and several years of daily chronic migraine.
But that’s not all – one of my sisters has migraine, and so do three of her five kids.
You could say the odds were stacked against my Spawn and my niece and nephews:￼
You might think that with such a prevalence of migraine in one’s immediate family, a child receiving a medical diagnosis of migraine is simple and obvious.
You’d be wrong.
Not your mother’s (or father’s) migraine
Migraine in kids can present very differently than in adults:
■ The head pain often affects the whole head rather than just one side.
■ Attacks are shorter, sometimes lasting less than an hour but often the pain will improve in between two and four hours.
■ The headache may disappear but the child may feel sick or be sick and this may be worse than the head pain. Sometimes being sick marks the end of an attack and brings relief from all the symptoms.
■ There may be abdominal pain and no head pain.
■ Often car sickness is an indicator of migraine.
■ The headache can come on very suddenly, and the child may be in severe pain in less than 15 minutes.
■ Some childhood syndromes like vomiting in cycles every few months for some hours, turning the head to one side for a few seconds and turning it back again, episodes of dizziness like the room is spinning, and colic as a baby can be predictors of migraine in later life.
My son had classic migraine without aura symptoms, but his attacks hit hard and fast and were often over within a few hours. For these and other reasons, his doctor thought he might have cluster headache instead. But close observation netted a diagnosis of migraine.
One of my nephews has abdominal migraine (migraine that causes abdominal pain rather than head pain). Had we not had a clear history of migraine in our family, it could have taken much longer (or not at all) to reach his diagnosis.
I suspect that I had abdominal migraine as a kid. My symptoms were extremely close to what my nephew experiences. However, even though my symptoms landed me in the hospital for two weeks of [inconclusive] tests and observation, I was never diagnosed with migraine as a child.
My experience is much more typical than those of my son and nephew.
Many migraine medications for adults have proven ineffective for children with migraine, or can cause adverse effects.
For example, my son experienced greatly elevated pain and an intense burning sensation after taking imitrex (sumatriptan). It was intolerable, and other abortives were no better. (Anyone can be allergic to or have adverse reactions to any medication, but considering that very few migraine medications are approved for use children, I thought it bore mentioning).
With that sort of reaction, he had to ride out his attacks and his only rescue medication was a pain medication, which he usually opted not to take because of how long its effects lasted – it incapacitated him longer than his migraine attacks did.
Interestingly, the majority of his attacks as an adult have been silent migraine (migraine that doesn’t cause pain, but can include incapacitating aura and other symptoms).
Doctor (and parent) knowledge is vital
General practitioners and pediatricians may not be knowledgeable in the diagnosis and treatment of migraine. It may be up to parents to choose what is best.
A qualified doctor and informed parents are always the best place to start.
That’s why Diamond Headache Clinic, the oldest and largest headache and migraine treatment center, created this slide show to help inform parents.
Presentation courtesy of Diamond Headache Clinic
Migraine in children is easily overlooked and/or undiagnosed when they display atypical symptoms. Knowing the signs is one of the most important things we can do for our kids.
Be well, or as well as you can,
**disclaimer – I am not affiliated with nor do I collect any form of revenue from Diamond Headache Clinic. My views are solely my own and are influenced by information from friends who have received treatment at the clinic and by its reputation.**